In a period of 6 years, up to January, 1980, the author has treated 248 cases of aorto-iliac artery disease. There were 109 cases of abdominal aortic aneurysm, and the remainder was obstructive aorto-iliac artery disease. All but 20% of elective abdominal aortic aneurysms were asymptomatic. There were 100 cases of elective abdominal aortic aneurysm resection with operative mortality of 2%. There were 19 cases of ruptured aortic aneurysm with hospital mortality of 47%. There were 49 cases of aorto-femoral artery bypasses with 6th year cumulative patency rate of 89% in aorto-femoral bypass with Dacron graft, and 69% in aorto-iliac artery bypass with Dacron graft, and 2 year cumulative patency rate of 75% in descending thoracic aorto-femoral artery bypass with Poly Tetra Fluoro Ethylene graft. There were 32 cases of axillo-femoral artery bypasses and 48 cases of femoral-femoral artery bypasses. The 3 year cumulative patency rate of axillo-femoral artery bypass with PTFE graft was 89%, and that of femoral-femoral artery bypass with PTFE was 85%. However, axillo-femoral artery bypass with Dacron graft had 3-year patency rate of 67% and femoral-femoral artery bypass with Dacron graft was 62%. The 4 year cumulative patency rate of axillo-femoral artery bypass with Dacron graft was 39%. The 5 year cumulative patency rate of femoral-femoral artery bypass with Dacron graft was 62%